Automated External D fib ill tiDefibrillation (()AED) · • Automatic internal cardioverter defibrillators • Pacemakers • Place the pads at least one inch / 3 centimeters away

AutomatedAutomated External

D fib ill tiDefibrillation (AED)( )

DAN AUTOMATED EXTERNAL DEFIBRILLATIONAutomated E t l

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Provider RegistrationExternal Defibrillation

Complete the following administrative paperwork

• Course Registration Form

• Statement of Understanding

• DAN Membership Form

• Other Administrative Procedures

• Introductions

• DAN Instructor and Staff

• DAN Provider Candidates

DAN AUTOMATED EXTERNAL DEFIBRILLATIONAutomated E t l

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Course OverviewExternal Defibrillation

• Sudden Cardiac Arrest

• Providing Care for Sudden Cardiac ArrestProviding Care for Sudden Cardiac Arrest

• Skills Development Overview

• Legal ConsiderationsLegal Considerations

• Troubleshooting and Safety Considerations

• Maintaining an AEDMaintaining an AED

• What is Divers Alert Network?

• Skills Development SessionSkills Development Session

• Exam and Review

Sudden Cardiac Arrest

SUDDEN CARDIAC ARRESTSudden

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Sudden Cardiac ArrestSudden Cardiac Arrest

What Is It?

• In Europe each year 700.000 people die from SCA, leading cause for people older then 35

• Causes of sudden cardiac arrest include:

• Heart Disease

• Electric Shock

What's Happening?

• Healthy heart pumps oxygenated blood throughout the body

• Most common cause of Sudden Cardiac Arrest is ventricular fibrillation (VF)


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Ventricular FibrillationSudden Cardiac Arrest

• An abnormal chaotic rhythm

• Heart quivers – no organised rhythmHeart quivers no organised rhythm

• Only definitive treatment is defibrillation


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Ventricular FibrillationSudden Cardiac Arrest

There are several causes of ventricular fibrillation including:

• Electrical shock

• Cardiovascular disease

• Most common health problem in dive fatalities

• Cardiovascular disease medications are the most common drugs used by divers involved in dive fatalities


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DefibrillationSudden Cardiac Arrest

• The application of an electric shock across the heart muscle

• Resets the heart and allows it to begin beating normally

• Time is the key to surviving cardiac arrest:

• For every minute, chance of survival drops 7 to 10 percent

• Risk of brain damage increases


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Cardiovascular Disease and DivingSudden Cardiac Arrest

• Average age of divers is increasing

• Average age of DAN Members is increasing

• Average age of dive fatalities is increasing

• Cardiac problems make up about 12 percent of all dive fatalities

• Cardiac problems account for nearly 30 percent of the dive fatalities for divers over 35


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Warning Signs of Sudden Cardiac ArrestSudden Cardiac Arrest

Can happen without warning, but sometimes there are warning signs. They include:

• Heavy pressure or squeezing pain or discomfort in the centre of the chest behind the breastbone

• Shoulder, arm, neck or jaw pain and radiating discomfortShoulder, arm, neck or jaw pain and radiating discomfort

• Shortness of breath

• SweatingSweating

• Nausea and vomiting

• DenialDenial

Providing CareProviding Care for

Sudden Cardiac ArrestArrest

PROVIDING CARE FOR SUDDEN CARDIAC ARRESTProviding Care f S dd

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Chain of Survivalfor Sudden Cardiac Arrest

• The four links of the chain are:

Early Advanced Lif S t

Early A t

Early CPR

Early D fib ill ti Life SupportAccess to

EMSCPR Defibrillation


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What About CPR?for Sudden Cardiac Arrest

Cardiopulmonary resuscitation (CPR) still necessary for survival

• Keeps the body oxygenated

• Delays the onset of brain damage

• However, it cannot reset the arresting heart and allow it to begin beating on its own


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What About CPR?for Sudden Cardiac Arrest

Rescuers should provide CPR:

• Until AED is attachedUntil AED is attached

• After 1 shock

• After a no-shock advisoryAfter a no shock advisory

• If the device is unavailable


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Using an AEDfor Sudden Cardiac Arrest

• Doesn't change the way you respond to an emergency

• Use the same ABC’s

• Airway

• Breathing

• CPR (Circulation)

• Add a D for defibrillation


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• Start CPR according to adult BLS sequence

• If alone and AED is near, start withIf alone and AED is near, start with applying the AED

• When AED arrives:

• Switch on the AED: if more than 1 rescuer, continue CPR while this is carried out

• Place the unit near the patient's head on the patient's left side

U it ill t ti• Unit will prompt your actions


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• Attach the defibrillator pads

• They are marked to show proper placementThey are marked to show proper placement

• Take time to do this correctly

• Must make a good connectionMust make a good connection

• Bare the chest

• Cut away clothes, wetsuit or bra material, ifCut away clothes, wetsuit or bra material, if necessary

• Dry the chest, if wet

• Possibly shave off chest hair


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• Attach the pads to the AED (if needed)

• Some AEDs begin analysing automaticallySome AEDs begin analysing automatically

• Others require the user to press an analyse button

• Don't touch or move the patient during analysis

• State “I’m clear. You’re clear. All clear.”

• Unit will prompt you to clear the patient and deliver the shock


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• Make sure that nobody touches the victim when you push the shock button

• AED delivers one shock

• Continue as directed by the voice/visual prompts


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• AED unit may also determine no shock required

• Immediately resume CPR at the ratio 30:2Immediately resume CPR at the ratio 30:2

• Follow voice / visual prompts

• Continue to follow prompts until:Continue to follow prompts until:

• Qualified help takes over

• Victim starts to wake upVictim starts to wake up

• You become exhausted


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When EMS Arrivesfor Sudden Cardiac Arrest

• Report the care provided

• You may be asked to continue to provideYou may be asked to continue to provide care briefly

• EMS may attach their own defibrillator to your pads or may remove them andyour pads or may remove them and attach their own pads


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Skills Overviewfor Sudden Cardiac Arrest

• Scene Safety Assessment

• Initial Assessment with Basic Life SupportInitial Assessment with Basic Life Support

• BLS with Supplemental Oxygen (Optional)

• Providing Care with an AEDProviding Care with an AED

• AED Equipment Maintenance

• Emergency Assistance PlanEmergency Assistance Plan


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Scene Safety Assessmentfor Sudden Cardiac Arrest

Remember S-A-F-E

• S - StopS Stop

• A - Assess scene

• F - Find and secure first aid,F Find and secure first aid, oxygen and AED units

• E - Exposure protection


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Initial Assessment with Basic Life Supportfor Sudden Cardiac Arrest

• Remember SAFE

• Unresponsive?Unresponsive?

• Shout for help

• Open airwayOpen airway


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Initial Assessment with Basic Life Supportfor Sudden Cardiac Arrest

• Not breathing normally?

• Activate EMSActivate EMS

• 30 chest compressions

• 2 rescue breaths / 30 compressions2 rescue breaths / 30 compressions


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Basic Life Support with Supplemental Oxygen (Optional)for Sudden Cardiac Arrest

• Remember S-A-F-E

• Perform initial assessment

• If breathing, use:

• Demand inhalator valvePerform initial assessment (BLS)

• Provide supplemental oxygen as soon as it becomes available

Demand inhalator valve

• Non-rebreather mask

• If not breathing:as soon as it becomes available If not breathing:

• Provide rescue breaths using an oronasal resuscitation mask with anresuscitation mask with an oxygen inlet


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Providing Care with an AED (scenarios)for Sudden Cardiac Arrest

• Unresponsive

• Shout for help

• Not breathing normally?

• Send or go for AED and call EMS• Send or go for AED and call EMS

• Call EMS

• CPR 30:2 until AED is attached

• Attach the defibrillator pads

• Allow the AED to analyse heart rhythm

• Don't touch the patient

If shock required:

• Follow the AED unit's prompts

• Visually and physically clear the patient

• Say “Clear”

Administer shock• Administer shock.

• Resume CPR 30:2 for 2 minutes


If no shock required:o s oc equ ed

• Continue CPR 30:2 until the injured person starts to wake up, open eyes and to breathe normally



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AED Equipment Maintenancefor Sudden Cardiac Arrest

Follow manufacturer recommendations for periodic equipment check

• Check Battery – must have enough power for one complete rescue

• Run self test

• Check expiration date on supplies

• Stock up after use

• Defibrillator pads

• First aid supplies including gloves

• Clean resuscitation mask

• Reassemble unit and store ready for use


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Emergency Assistance Planfor Sudden Cardiac Arrest

Diver Information

• Name

General Information

• Emergency contact informationName

• Age or Date of birth

• Address

Emergency contact information (EMS, DAN)

• Initial contact phone number (Call back #)Address

• Emergency contact phone

• Current complaint(s)

(Call back #)

• Directions to nearest medical facilityCurrent complaint(s)

• Past medical history including current medication

• DAN phone numbers

• Other• Dive profile(s)

• Drug allergies

Legal Considerations

LEGAL CONSIDERATIONSLegal

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AEDs and the LawLegal Considerations

• In some countries, AEDs are classified as medical devices

• Regulations and administrative codes vary widely

• Check with DAN for more specific information for your area

LEGAL CONSIDERATIONSLegal

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AEDs and the LawLegal Considerations

• In many countries there are Good Samaritan Laws

• No cases where lay rescuers have been successfully sued for providing care with an AED

• Protects rescuers who:

• Voluntarily provide assistance and are not legally obligated

• Expect nothing in return

• Are not grossly negligent

TroubleshootingTroubleshooting and

Safety ConsiderationsConsiderations

TROUBLESHOOTING AND SAFETY CONSIDERATIONSTroubleshooting

d S f t

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Troubleshootingand Safety Considerations

• The primary reason an AED cannot analyse a heart rhythm is poor pad connection. Make sure:

• Pads are firmly attached

• Pads aren't damaged

• Pads are plugged in completely

• There’s no hair or moisture under the padt e pad

• Other considerations include:

• Stop all movement

• Do not touch the patient

• Check for a low battery


d S f t

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Safety Considerationsand Safety Considerations

Only attach an AED unit to a person that:

• Is unresponsiveIs unresponsive

• Is not breathing normally

Do not attach an AED Do not attach an AED to a responsive person


d S f t

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• Move supplemental oxygen away

• Clear the patientClear the patient

• Remove the patient from standing water

• Safe to use around wet environments like a pool, boat or in the rain

• However, don't immerse it or spill liquid on it


d S f t

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• Some people wear implanted devices such as:

• Automatic internal cardioverter defibrillators

• Pacemakers

• Place the pads at least one inch / 3 centimeters away from the implanted device

• AED’s and children:

• Standard AED’s are suitable for use in Children older than 8 years.

• For children between 1 and 8 years, use pedriatic pads or a pediatric mode if availablepediatric mode if available

• If not available, use the AED as it is.

• Use of AED’s not recommended for children less than 1 yearUse of AED s not recommended for children less than 1 year

Maintaining an AED

MAINTAINING AN AEDMaintaining an

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MaintenanceMaintaining an AED

• Follow manufacturers’ recommendations

• Check the status regularlyCheck the status regularly

• Check the batteries and all the supplies and spares in the kit

• They are all dated, so you need to make sure you have not exceeded any of those dates

• If available, make sure the spare PC card is in the unit and ready

MAINTAINING AN AEDMaintaining an

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MaintenanceMaintaining an AED

Perform a Battery Insertion Test

• Remove the battery and then replace it

• The unit will perform an automatic self-test

• If the Battery Insertion Test fails, replace the battery

What isDivers AlertDivers Alert Network?

WHAT IS DIVERS ALERT NETWORK?What isDi Al t

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The Mission of DANDivers Alert Network?

• Divers Alert Network (DAN), a nonprofit organisation, exists to provide expert information and advice consistent with current medical literatureliterature

• Provides emergency medical advice and assistance for underwater scuba diving accidents, works to prevent accidents and promotes diving safetydiving safety


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The Mission of DANDivers Alert Network?

• Promotes and supports underwater diving research and education, particularly as it relates to the improvement of diving safety, first aid and medical treatmentand medical treatment

• Provides accurate, up-to-date, and unbiased information on issues of common concern to the diving public, and advocates for divers' concerns for diving safetyconcerns for diving safety


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DAN ServicesDivers Alert Network?

• DAN Medicine

• Diving Emergency Hotline

• DAN Membership

• DAN Travel AssistDiving Emergency Hotline

• Diving Medicine Information

• Chamber Assistance

DAN Travel Assist

• Alert Diver

• Dive accident and liabilityChamber Assistance

• DAN Training

Dive accident and liability insurance

• DAN Research

DAN AUTOMATED EXTERNAL DEFIBRILLATIONCourse

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Course SummaryCourse Summary

In this course, you learned about:

• Sudden Cardiac Arrest

• Providing Care for Sudden Cardiac Arrest

• Skills Development Session

• Legal Considerations

• Troubleshooting and Safety Considerations

• Maintaining An AED

• What is Divers Alert Network?

Documents

Automated External D fib ill tiDefibrillation (()AED) · • Automatic internal cardioverter defibrillators • Pacemakers • Place the pads at least one inch / 3 centimeters away